Comment by pc86 | Hacker News Reader

Comment by pc86 | Hacker News Reader

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I've told this story here before, but I grew up with very health-illiterate parents, who were very "old school" in the sense that if anyone in a white coat said something, it was gospel. Doctor, dentist, nurse, whatever (curiously they had and still have extremely negative opinions of medical paraprofessionals like PAs and NPs).

Anyway, I was around 15 or 16 and had always had perfect dental checkups. One day I had another routine checkup, but now suddenly I had to get nine fillings. I asked my parents to get a second opinion, but they refused and I got the fillings. In a move that would surprise absolutely nobody, that dentist sold the practice a few months later. I'm 100% confident that he was just goosing his revenue to increase the sales price, or make it a more attractive acquisition based on the revenue trend. That was around 20 years ago and I haven't had a single other dental issue beyond getting my wisdom teeth removed a few years later.

I think dental care is super important, but dentists are concerned primarily with maximizing their revenue in a way that would get most physicians' licenses revoked.

Now I'm grateful for my parents' choice of dentist. She worked out of a small office attached to the back of her home, and had family members as office staff. This is in the 90's in a very posh suburb of a major city, not some backwater a long time ago. Anyways, that dentist always had unique advice, she told me that if I were going to only do either brushing or flossing, that I should do the flossing and skip the brushing. Doing both is better, but she observed that many people skip flossing too much. She also said that toothpaste was largely superficial, and good brushing without toothpaste was just as good. She also would spend lots of time literally demonstrating good brushing technique and explaining why to do it that way. I also have some slightly crooked teeth, she said to push them with my tongue instead of getting braces. When I grew up, before going to college, she advised me that I don't really need to see a dentist regularly as an adult, and my teeth will be alright as long as I continue brushing and flossing. Cool somewhat hippy dentist was right on all accounts, and I've had good dental health ever since. Another anecdote: she would trade dental services for my dad fixing her various dental machines and equipment. Not sure how that arrangement came about, my dad wasn't really qualified or anything, he was just pretty handy and usually managed to fix things more than break them. And it wasn't disguised charity or anything, we had no issues paying. Pretty cool dentist.

I've heard the "flossing more important than brushing" from a number of sources, and it makes sense; it can be a pain but it's literally getting at areas that your lips and tongue can't.

Interesting. A similar thing happened to me. After a lifetime of zero cavities, the dentist I'd seen a few times for cleanings announces that my luck has run out -- I've got several cavities. I declined any work, but I was concerned. Shortly after that I ended up moving to a different state and it was about year before I got back in to a new dentist. I was dreading it since I figured he'd tell me I've got cavities. Nope -- said everything looks great, see you in 6 months!

Worse happened to me. I had no cavities until the age of 36. Then I apparently got two. New dentist. I went for a second opinion and a second new dentist confirmed it, but who knows. I got the fillings. Within six weeks, one of the teeth broke in half around the filling and the guy was trying to give me an emergency root canal. I ended up having to have it pulled. The other one broke in half a few months later, another emergency surgery. That time, I went in and I'm pretty sure he worked on me drunk.

I haven't tried to sue the guy, but I think seriously about firebombing his office every time I drive by it.

There must be options in between suing him and firebombing his office. Seriously, think about folks coming in after you. Try to at least file a complaint, or give a bad review some place.

A few years ago, a friend of my cousin became a licensed dentist here in Sweden. My cousin had to remove a tooth and his friend gave him, I assume, a lower price because they're friends...

He removed a tooth alright, but the wrong one (on the wrong side). And apparently my cousin just assumed he worked on fixing something else, realising the mistake way too late.

I asked my cousin if he considered suing but he didn't want to do that because they're friends...

Weird situation.

Reminds me of people getting "THIS LEG" tattooed on the leg to be removed, perhaps something similar with a stick on tooth decoration could be worth it.

I used to live in Spain, and I remember being shocked when my doctor told me how common it was for people to have the wrong leg or kidney removed there. She was originally American, and implied there was a strong inverse correlation between the cap on malpractice damages and the number of incorrect organs/appendages detached. Honestly, although the American medical system is the pits, it gave me a better opinion of American tort law and made me believe that some of the seemingly superficial lawsuits in this country serve a better purpose of keeping the otherwise wild-west medical system in check.

[edit] just as a side note, I've noticed a strong trend here among people who also never "had a cavity" in another country until they were in the US

There was some pretty significant pressure against having doctors use checklists (like pilots have) - but it has also decreased errors significantly (both in aviation and in the medical field).

They also act as a form of documentation; I highly recommend checklists whenever I can.

It almost seems like tattooing "NOT THIS LEG" would be a safer move.

> curiously they had and still have extremely negative opinions of medical paraprofessionals like PAs and NPs

This isn't entirely unfounded. There are real concerns over replacing MDs with mid-levels with much less training. The AMA is significantly to blame for the switch, but as a general rule I won't see PA/NPs for anything beyond prescription refills or something like that.

But that routine care is a good case for PAs/NPs. Pulling blood once and year and refilling my inhaler doesn’t require any speciality knowledge that only an MD would have. Most people shouldn’t have any reason to avoid one for their annual check or treating a run-of-the-mill illness.

Even that is arguable; I'd rather see an MD for an annual physical. It seems like a routine thing to people not in the medical field, but there are a ton of little things that are checked and could be caught early. I'd rather have an actual doctor performing it.

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